tbuckley/cabot-search huggingface dataset:
The Pathways to Prevention program: nutrition as prevention for improved cancer outcomes
Authors: Robert A Hiatt, Margaret F Clayton, Karen K Collins, Heather T Gold, Adeyinka O Laiyemo, Kimberly Parker Truesdale, Debra P Ritzwoller
Journal: JNCI Journal of the National Cancer Institute (2023)

Abstract Adequate nutrition is central to well-being and health and can enhance recovery during illness. Although it is well known that malnutrition, both undernutrition and overnutrition, poses an added challenge for patients with cancer diagnoses, it remains unclear when and how to intervene and if such nutritional interventions improve clinical outcomes. In July 2022, the National Institutes of Health convened a workshop to examine key questions, identify related knowledge gaps, and provide recommendations to advance understanding about the effects of nutritional interventions. Evidence presented at the workshop found substantial heterogeneity among published randomized clinical trials, with a majority rated as low quality and yielding mostly inconsistent results. Other research cited trials in limited populations that showed potential for nutritional interventions to reduce the adverse effects associated with malnutrition in people with cancer. After review of the relevant literature and expert presentations, an independent expert panel recommends baseline screening for malnutrition risk using a validated instrument following cancer diagnosis and repeated screening during and after treatment to monitor nutritional well-being. Those at risk of malnutrition should be referred to registered dietitians for more in-depth nutritional assessment and intervention. The panel emphasizes the need for further rigorous, well-defined nutritional intervention studies to evaluate the effects on symptoms and cancer-specific outcomes as well as effects of intentional weight loss before or during treatment in people with overweight or obesity. Finally, although data on intervention effectiveness are needed first, robust data collection during trials is recommended to assess cost-effectiveness and inform coverage and implementation decisions.
Avoiding and Identifying Reversal of Left Arm and Left Leg Leads—Reply
Authors: Li Wang, Caiyun Duan, Lan Ma
Journal: JAMA Internal Medicine (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Optimizing Age-Specific Outcomes After Mechanical vs Bioprosthetic Prosthetic Heart Valve Replacement
Authors: Catherine M. Otto
Journal: JAMA Network Open (2023)

Sung Jun Park, MD; You Jung Ok, MD; Ho Jin Kim, MD; Ye-Jee Kim, PhD; Seonok Kim, MSc; Jung-Min Ahn, MD, PhD; Dae-Hee Kim, MD, PhD; Jae-Sung Choi, MD, PhD; Joon Bum Kim, MD, PhD
miR-147 Represses NDUFA4, Inducing Mitochondrial Dysfunction and Tubular Damage in Cold Storage Kidney Transplantation
Authors: Jiefu Zhu, Xiaohong Xiang, Xiaoru Hu, Chenglong Li, Zhixia Song, Zheng Dong
Journal: Journal of the American Society of Nephrology (2023)

Cold storage-associated transplantation (CST) injury occurs in renal transplant from deceased donors, the main organ source. The pathogenesis of CST injury remains poorly understood, and effective therapies are not available. This study has demonstrated an important role of microRNAs in CST injury and revealed the changes in microRNA expression profiles. Specifically, microRNA-147 (miR-147) is consistently elevated during CST injury in mice and in dysfunctional renal grafts in humans. Mechanistically, NDUFA4 (a key component of mitochondrial respiration complex) is identified as a direct target of miR-147. By repressing NDUFA4, miR-147 induces mitochondrial damage and renal tubular cell death. Blockade of miR-147 and overexpression of NDUFA4 reduce CST injury and improve graft function, unveiling miR-147 and NDUFA4 as new therapeutic targets in kidney transplantation.
Avoiding and Identifying Reversal of Left Arm and Left Leg Leads
Authors: Mazen M. Kawji
Journal: JAMA Internal Medicine (2023)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Consensus summary statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care
Authors: Peter Le Roux, David K. Menon, Giuseppe Citerio, Paul Vespa, Mary Kay Bader, Gretchen M. Brophy, Michael N. Diringer, Nino Stocchetti, Walter Videtta, Rocco Armonda, Neeraj Badjatia, Julian Böesel, Randall Chesnut, Sherry Chou, Jan Claassen, Marek Czosnyka, Michael De Georgia, Anthony Figaji, Jennifer Fugate, Raimund Helbok, David Horowitz, Peter Hutchinson, Monisha Kumar, Molly McNett, Chad Miller, Andrew Naidech, Mauro Oddo, DaiWai Olson, Kristine O’Phelan, J. Javier Provencio, Corinna Puppo, Richard Riker, Claudia Robertson, Michael Schmidt, Fabio Taccone
Journal: Intensive Care Medicine (2014)
Prevalence and clinical expression of germ line predisposition to myeloid neoplasms in adults with marrow hypocellularity
Authors: Elisabetta Molteni, Elisa Bono, Anna Gallì, Chiara Elena, Jacqueline Ferrari, Nicolas Fiorelli, Sara Pozzi, Virginia Valeria Ferretti, Martina Sarchi, Ettore Rizzo, Virginia Camilotto, Emanuela Boveri, Mario Cazzola, Luca Malcovati
Journal: Blood (2023)

Abstract Systematic studies of germ line genetic predisposition to myeloid neoplasms in adult patients are still limited. In this work, we performed germ line and somatic targeted sequencing in a cohort of adult patients with hypoplastic bone marrow (BM) to study germ line predisposition variants and their clinical correlates. The study population included 402 consecutive adult patients investigated for unexplained cytopenia and reduced age-adjusted BM cellularity. Germ line mutation analysis was performed using a panel of 60 genes, and variants were interpreted per the American College of Medical Genetics and Genomics/Association for Molecular Pathology guidelines; somatic mutation analysis was performed using a panel of 54 genes. Of the 402 patients, 27 (6.7%) carried germ line variants that caused a predisposition syndrome/disorder. The most frequent disorders were DDX41-associated predisposition, Fanconi anemia, GATA2-deficiency syndrome, severe congenital neutropenia, RASopathy, and Diamond-Blackfan anemia. Eighteen of 27 patients (67%) with causative germ line genotype were diagnosed with myeloid neoplasm, and the remaining with cytopenia of undetermined significance. Patients with a predisposition syndrome/disorder were younger than the remaining patients and had a higher risk of severe or multiple cytopenias and advanced myeloid malignancy. In patients with myeloid neoplasm, causative germ line mutations were associated with increased risk of progression into acute myeloid leukemia. Family or personal history of cancer did not show significant association with a predisposition syndrome/disorder. The findings of this study unveil the spectrum, clinical expressivity, and prevalence of germ line predisposition mutations in an unselected cohort of adult patients with cytopenia and hypoplastic BM.
Calcineurin inhibitor inhibits tolerance induction by suppressing terminal exhaustion of donor T cells after allo-HCT
Authors: Hajime Senjo, Shinpei Harada, Shimpei I. Kubota, Yuki Tanaka, Takahiro Tateno, Zixuan Zhang, Satomi Okada, Xuanzhong Chen, Ryo Kikuchi, Naoki Miyashita, Masahiro Onozawa, Hideki Goto, Tomoyuki Endo, Yuta Hasegawa, Hiroyuki Ohigashi, Takahide Ara, Yoshinori Hasegawa, Masaaki Murakami, Takanori Teshima, Daigo Hashimoto
Journal: Blood (2023)
National Trends in Hyperglycemia and Diabetic Ketoacidosis in Children, Adolescents, and Young Adults With Type 1 Diabetes: A Challenge Due to Age or Stage of Development, or Is New Thinking About Service Provision Needed?
Authors: Naomi Holman, Emilia Woch, Colin Dayan, Justin Warner, Holly Robinson, Bob Young, Jackie Elliott
Journal: Diabetes Care (2023)

Adolescence is associated with high-risk hyperglycemia. This study examines the phenomenon in a life course context.A total of 93,125 people with type 1 diabetes aged 5 to 30 years were identified from the National Diabetes Audit and/or the National Paediatric Diabetes Audit for England and Wales for 2017/2018-2019/2020. For each audit year, the latest HbA1c and hospital admissions for diabetic ketoacidosis (DKA) were identified. Data were analyzed in sequential cohorts by year of age.In childhood, unreported HbA1c measurement is uncommon; however, for 19-year-olds, it increases to 22.3% for men and 17.3% for women, and then reduces to 17.9% and 13.1%, respectively, for 30-year-olds. Median HbA1c for 9-year-olds is 7.6% (60 mmol/mol) (interquartile range 7.1-8.4%, 54-68 mmol/mol) in boys and 7.7% (61 mmol/mol) (8.0-8.4%, 64-68 mmol/mol) in girls, increasing to 8.7% (72 mmol/mol) (7.5-10.3%, 59-89 mmol/mol) and 8.9% (74 mmol/mol) (7.7-10.6%, 61-92 mmol/mol), respectively, for 19-year-olds before falling to 8.4% (68 mmol/mol) (7.4-9.7%, 57-83 mmol/mol) and 8.2% (66 mmol/mol) (7.3-9.7%, 56-82 mmol/mol), respectively, for 30-year-olds. Annual hospitalization for DKA rose steadily in age from 6 years (2.0% for boys, 1.4% for girls) and peaked at 19 years for men (7.9%) and 18 years for women (12.7%), reducing to 4.3% for men and 5.4% for women at age 30 years. For all ages over 9 years, the prevalence of DKA was higher in female individuals.HbA1c and the prevalence of DKA increase through adolescence and then decline. Measurement of HbA1c, a marker of clinical review, falls abruptly in the late teenage years. Age-appropriate services are needed to overcome these issues.
Dimethyl fumarate treatment in relapsed and refractory cutaneous T-cell lymphoma: a multicenter phase 2 study
Authors: Jan P. Nicolay, Susanne Melchers, Jana D. Albrecht, Chalid Assaf, Edgar Dippel, Rudolf Stadler, Ulrike Wehkamp, Marion Wobser, Jing Zhao, Ina Burghaus, Sven Schneider, Karsten Gülow, Sergij Goerdt, Christian M. Schürch, Jochen S. Utikal, Peter H. Krammer
Journal: Blood (2023)

Abstract Targeted therapies for cutaneous T-cell lymphoma (CTCL) are limited and curative approaches are lacking. Furthermore, relapses and drug induced side effects are major challenges in the therapeutic management of patients with CTCL, creating an urgent need for new and effective therapies. Pathologic constitutive NF-κB activity leads to apoptosis resistance in CTCL cells and, thus, represents a promising therapeutic target in CTCL. In a preclinical study we showed the potential of dimethyl fumarate (DMF) to block NF-κB and, specifically, kill CTCL cells. To translate these findings to applications in a clinical setting, we performed a multicentric phase 2 study evaluating oral DMF therapy in 25 patients with CTCL stages Ib to IV over 24 weeks (EudraCT number 2014-000924-11/NCT number NCT02546440). End points were safety and efficacy. We evaluated skin involvement (using a modified severity weighted assessment tool [mSWAT]), pruritus, quality of life, and blood involvement, if applicable, as well as translational data. Upon skin analysis, 7 of 23 (30.4%) patients showed a response with &amp;gt;50% reduction in the mSWAT score. Patients with high tumor burden in the skin and blood responded best to DMF therapy. Although not generally significant, DMF also improved pruritus in several patients. Response in the blood was mixed, but we confirmed the NF-κB–inhibiting mechanism of DMF in the blood. The overall tolerability of the DMF therapy was very favorable, with mostly mild side effects. In conclusion, our study presents DMF as an effective and excellently tolerable therapeutic option in CTCL to be further evaluated in a phase 3 study or real-life patient care as well as in combination therapies. This trial was registered at www.clinicaltrials.gov as #NCT02546440.
Acetazolamide for metabolic alkalosis complicating respiratory failure with chronic obstructive pulmonary disease or obesity hypoventilation syndrome: a systematic review
Authors: Timothy John Bemand, Richard Chatoor, Patrizia Natale, Giovanni Strippoli, Anthony Delaney
Journal: Thorax (2023)

Background Metabolic alkalosis may lead to respiratory inhibition and increased need for ventilatory support or prolongation of weaning from ventilation for patients with chronic respiratory disease. Acetazolamide can reduce alkalaemia and may reduce respiratory depression. Methods We searched Medline, EMBASE and CENTRAL from inception to March 2022 for randomised controlled trials comparing acetazolamide to placebo in patients with chronic obstructive pulmonary disease, obesity hypoventilation syndrome or obstructive sleep apnoea, hospitalised with acute respiratory deterioration complicated by metabolic alkalosis. The primary outcome was mortality and we pooled data using random-effects meta-analysis. Risk of bias was assessed using the Cochrane RoB 2 (Risk of Bias 2) tool, heterogeneity was assessed using the I 2 value and χ 2 test for heterogeneity. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. Results Four studies with 504 patients were included. 99% of included patients had chronic obstructive pulmonary disease. No trials recruited patients with obstructive sleep apnoea. 50% of trials recruited patients requiring mechanical ventilation. Risk of bias was overall low to some risk. There was no statistically significant difference with acetazolamide in mortality (relative risk 0.98 (95% CI 0.28 to 3.46); p=0.95; 490 participants; three studies; GRADE low certainty) or duration of ventilatory support (mean difference −0.8 days (95% CI −7.2 to 5.6); p=0.36; 427 participants; two studies; GRADE: low certainty). Conclusion Acetazolamide may have little impact on respiratory failure with metabolic alkalosis in patients with chronic respiratory diseases. However, clinically significant benefits or harms are unable to be excluded, and larger trials are required. PROSPERO registration number CRD42021278757.
A deep-learning radiomics-based lymph node metastasis predictive model for pancreatic cancer: a diagnostic study
Authors: Ningzhen Fu, Wenli Fu, Haoda Chen, Weimin Chai, Xiaohua Qian, Weishen Wang, Yu Jiang, Baiyong Shen
Journal: International Journal of Surgery (2023)

Preoperative lymph node (LN) status is essential in formulating the treatment strategy among pancreatic cancer patients. However, it is still challenging to evaluate the preoperative LN status precisely now.A multivariate model was established based on the multiview-guided two-stream convolution network (MTCN) radiomics algorithms, which focused on primary tumor and peri-tumor features. Regarding discriminative ability, survival fitting, and model accuracy, different models were compared.Three hundred and sixty-three pancreatic cancer patients were divided in to train and test cohorts by 7:3. The modified MTCN (MTCN+) model was established based on age, CA125, MTCN scores, and radiologist judgement. The MTCN+ model outperformed the MTCN model and the artificial model in discriminative ability and model accuracy. [Train cohort area under curve (AUC): 0.823 vs. 0.793 vs. 0.592; train cohort accuracy (ACC): 76.1 vs. 74.4 vs. 56.7%; test cohort AUC: 0.815 vs. 0.749 vs. 0.640; test cohort ACC: 76.1 vs. 70.6 vs. 63.3%; external validation AUC: 0.854 vs. 0.792 vs. 0.542; external validation ACC: 71.4 vs. 67.9 vs. 53.5%]. The survivorship curves fitted well between actual LN status and predicted LN status regarding disease free survival and overall survival. Nevertheless, the MTCN+ model performed poorly in assessing the LN metastatic burden among the LN positive population. Notably, among the patients with small primary tumors, the MTCN+ model performed steadily as well (AUC: 0.823, ACC: 79.5%).A novel MTCN+ preoperative LN status predictive model was established and outperformed the artificial judgement and deep-learning radiomics judgement. Around 40% misdiagnosed patients judged by radiologists could be corrected. And the model could help precisely predict the survival prognosis.
Systemic mastocytosis in adults: 2023 update on diagnosis, risk stratification and management
Authors: Animesh Pardanani
Journal: American Journal of Hematology (2023)

Systemic mastocytosis (SM) results from clonal proliferation of mast cells (MC) in extracutaneous organs.The major criterion is presence of multifocal MC clusters in the bone marrow and/or extracutaneous organs. Minor diagnostic criteria include elevated serum tryptase level, MC CD25/CD2/CD30 expression, and presence of activating KIT mutations.Establishing SM subtype as per the International Consensus Classification/World Health Organization classification systems is an important first step. Patients either have indolent/smoldering SM (ISM/SSM) or advanced SM, including aggressive SM (ASM), SM with associated myeloid neoplasm (SM-AMN), and mast cell leukemia. Identification of poor-risk mutations (i.e., ASXL1, RUNX1, SRSF2, NRAS) further refines the risk stratification. Several risk models are available to help assign prognosis in SM patients.Treatment goals for ISM patients are primarily directed toward anaphylaxis prevention/symptom control/osteoporosis treatment. Patients with advanced SM frequently need MC cytoreductive therapy to reverse disease-related organ dysfunction. Tyrosine kinase inhibitors (TKI) (midostaurin, avapritinib) have changed the treatment landscape in SM. While deep biochemical, histological and molecular responses have been documented with avapritinib treatment, its efficacy as monotherapy against a multimutated AMN disease component in SM-AMN patients remains unclear. Cladribine continues to have a role for MC debulking, whereas interferon-α has a diminishing role in the TKI era. Treatment of SM-AMN primarily targets the AMN component, particularly if an aggressive disease such as acute leukemia is present. Allogeneic stem cell transplant has a role in such patients. Imatinib has a therapeutic role only in the rare patient with an imatinib-sensitive KIT mutation.
Are contraction and relaxation coupled in patients with and without congestive heart failure?
Authors: E J Eichhorn, J E Willard, L Alvarez, A S Kim, D B Glamann, R C Risser, P A Grayburn
Journal: Circulation (1992)

BACKGROUND Although changes in contractility are often accompanied by changes in relaxation, a mathematical model of ventricular coupling has not been described. A model we examined suggests a hyperbolic relation between measurements of contraction and relaxation. We thus tested the hypothesis that relatively load-independent measurements of contractility (end-systolic elastance [Ees]) and relaxation (the slope of the tau-to-end-systolic pressure relation [R]) were coupled. METHODS AND RESULTS To establish the validity of the model, an assessment of Ees and R was made in 30 subjects who underwent sequential digital ventriculography and micromanometer pressure measurements during atrial pacing (93 +/- 10 min-1) before and after graded doses of nitroprusside. To establish if a cyclic AMP (cAMP)-mediated intervention alters coupling, seven of the 30 subjects were studied before and after 3 months of beta-blockade. To determine if a non-cAMP-mediated intervention alters coupling, 12 other patients were studied before and after deslanoside. Nonlinear regression analysis for the initial 30 patients suggested a hyperbolic relation: (Ees) (R) = 1.05 (r = 0.79, p less than 0.001) with an inflection point near Ees = 1.02 mm Hg/ml. Thus, with normal or near-normal contractility, relaxation is normal and not load dependent (R is close to 0). With systolic dysfunction, relaxation becomes very afterload dependent and so must be normalized for load. After long-term beta-blockade in patients with severe left ventricular dysfunction, small improvements in contractility (elastance) occurred with larger changes in relaxation, but the curve describing the relation was not displaced. Acute administration of deslanoside resulted in a large increase in elastance and a smaller change in relaxation but did not alter coupling. However, the magnitude of the change in R was dependent on the predrug R value. CONCLUSIONS These data suggest contraction and relaxation may be physiologically coupled with relaxation relatively preserved in early heart failure and more rapid deterioration in relaxation as elastance falls under 1.02 mm Hg/ml. Both beta-blockers (which may act through cAMP) and digitalis (which is cAMP independent) improve contraction and relaxation, but both mechanisms appear to maintain coupling. The hyperbolic relation between contraction and relaxation may have important implications regarding therapeutic response and selection of patients for clinical trials in heart failure.
Cerebral small vessel disease pathology in COVID-19 patients: A systematic review
Authors: Cameron D. Owens, Camila Bonin Pinto, Sam Detwiler, Peter Mukli, Anna Peterfi, Zsofia Szarvas, Jordan R. Hoffmeister, Juliette Galindo, Jila Noori, Angelia C. Kirkpatrick, Tarun W. Dasari, Judith James, Stefano Tarantini, Anna Csiszar, Zoltan Ungvari, Calin I. Prodan, Andriy Yabluchanskiy
Journal: Ageing Research Reviews (2023)
Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with cardiac arrest: a comparative meta-analysis and trial sequential analysis
Authors: Christopher Jer Wei Low, Kollengode Ramanathan, Ryan Ruiyang Ling, Maxz Jian Chen Ho, Ying Chen, Roberto Lorusso, Graeme MacLaren, Kiran Shekar, Daniel Brodie
Journal: The Lancet Respiratory Medicine (2023)